[Heroin abuse, autobiographical memory and depression]

The early psychiatric interviews with opiate addicts are characterized by three features: 1) the patient has a very factual and objective conversation, 2) the evaluation of the autobiographical memory is very difficult, 3) there is a high prevalence of affective disorders responsible for an impairment in cognitive functions. Therefore we have two aims: First, to compare episodic and semantic autobiographical memory in opiate addicts and healthy controls. Autobiographical memory is the knowledge a person has about oneself and his past. Personal semantic memory is the knowledge of the biographical facts, general knowledge and beliefs about oneself. Autobiographical episodic memory concerns recollections of personal events clearly delineated in time and space. Second, to estimate the impact of depression on the ability to produce autobiographical recollection in a population of opiatre addicts. Participants were consecutive attenders of a methadone outpatient clinic who are multiple drug dependent patients consuming mainly heroine. The first investigation took place in entry and after two months. We have recruited 21 patients with a mean duration of intoxication of 11 years. Ten of these patients have been investigated again after 2 months and 8 of them have been included in a methadone maintenance program. The patients'investigation comprised two parts: first, the evaluation of autobiographical memory (only assessed at entry of the study) with an autobiographical fluency test and the semi-structured autobiographical memory interview of Kopelman; second, the psychiatric assessment included self-rating questionnaires and observer-rating questionnaires. Opiate addicts showed a decrease in episodic autobiographical memory but an increase in semantic affective memory and objective modalization. In the fluency test, there was no difference in the number of evoked items between opiate addicts and healthy controls. The educational level influences several results. The possible explanations of these results are the action of the toxic products and a particular psychic functioning. The lack of correlation between autobiographical memory and affective disorder suggests the implication of the drugs in the emergence of memory deficits. The improvement of depressive symptomatology after two months occurring without psychotropic drugs suggests the transient feature of depression and emphasises on non-pharmacological aspects of treatment.